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To summarize the evidence relating diet and nutrition to the two hallmark biomarkers of AD

Approximately 44 million people worldwide have Alzheimer’s disease. Alzheimer’s disease (AD) is the leading cause of dementia, reporting an annual global cost of $605b USD and is therefore a global health priority. Currently, pharmaceuticals lack efficacy in the Alzheimer’s disease pathology and research is growing regarding the influence of diet on Alzheimer’s disease development. Diet and nutrition may play a crucial role in the Alzheimer’s disease symptomatology and offer great potential for non-pharmacological prevention. Summaries of the existing evidence reveal an association between diet and the incidence and prevalence of Alzheimer’s disease, yet few studies have investigated this relationship with respect to physical biomarkers. The aim of the current systematic review is to summarize the evidence relating diet and nutrition to the two hallmark biomarkers of Alzheimer’s disease; tau and beta-amyloid, to identify methodological constraints in these studies and provide to provide directions for future research.

Abstract

Most of the recent reports suggest that inflammatory mediators play a central role in the etiopathogenesis of Alzheimer's disease (AD) and that the conditions leading to a chronic low-grade inflammation, such as stress, depression, obesity and metabolic syndrome, increase the odds of developing Mild Cognitive Impairment (MCI) and AD. Microglia cells are the main actors in the AD process: stimuli from the microenvironment may induce microglia cells to switch to a classically activated inflammatory phenotype M1, or, on the contrary to an alternatively activated M2 phenotype characterized by the secretion of different types of cytokines. Many attempts are currently being made in order to delay the progression of AD by reducing inflammatory mechanisms underlying the disease. Several studies support a relationship among neuroinflammation and nutrients, foods or dietary patterns, taking into account the synergistic or antagonistic biochemical interactions among nutrients as well as the different food sources of the same nutrient. Natural antioxidant and anti-inflammatory compounds found in plant food matrices, like fruits, especially berries (such as strawberry, bilberry, blackcurrant, blackberry, blueberry and mulberry) offer a possible neuroprotective effects. It is still unclear whether the dietary bioactive compounds enter the Blood Brain Barrier (BBB) playing a direct anti-inflammatory or pro-inflammatory effect on microglia and/or other Central Nervous System (CNS) cells. Another hypothesis is that they may trigger a peripheral reaction that induce indirectly a CNS' response. The subsequent synthesis of cytokines may drive microglia polarization by different ways. So, via an indirect route microglia detects and responds to signals emerging from immune-to-brain signaling pathways. This review summarizes current evidence about the potential mechanisms of the interaction among diet, neuroinflammation and AD.

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